None listed
Conditions
Brief summary
Empyema is the accumulation of infective fluid around the lung and occurs in about 1 percent of pneumonias in children. The bacterium Streptococcus pneumoniae is a leading cause of empyema. There has been a national vaccination program in Australia for the past 5 years which covers 7 types of Streptococcus. There is evidence in other countries that a type called Serotype 1 is emerging and this is not covered by the vaccine in this country. There is also evidence that following the introduction of the vaccine in other countries there has been a rise in the number of empyemas in children. The aim of this project is to accurately assess the types of Streptococcus causing empyemas in children in Australia using molecular techniques which can increase our identification of the bacteria causing empyema greater than our current standard techniques. The significance of the project is that it has the potential to affect the national vaccination program. If the project highlights that there is a large proportion of types of Streptococcus causing disease in children not covered by the current vaccine, then it may influence the Department of Health and Ageing in changing to another vaccine with a broader coverage. In addition, it is not known how best to manage children with empyemas and we will get data from different sites on how they are treating these children. We aim to develop a position paper for the Australian Paediatric Respiratory Group on managing children with this disease in Australia.
Interventions
To obtain an accurate assessment of the disease burden among children with parapneumonic effusions and empyema associated with S.pneumoniae, the aim is to enrol children with parapneumonic effusions or empyema over a twenty four month period from all children presenting to paediatric hospitals throughout Australia and to Auckland, New Zealand. Clinical data on demographics, vaccination status, presentation, management and outcome will be obtained. Pleural effusions and empyema fluid specimens wi
To obtain an accurate assessment of the disease burden among children with parapneumonic effusions and empyema associated with S.pneumoniae, the aim is to enrol children with parapneumonic effusions or empyema over a twenty four month period from all children presenting to paediatric hospitals throughout Australia and to Auckland, New Zealand. Clinical data on demographics, vaccination status, presentation, management and outcome will be obtained. Pleural effusions and empyema fluid specimens will be cultured, and analysis will be performed to describe the distribution of hospitalized children with culture-positive and culture-negative parapneumonic effusions and empyema. Children with culture-negative pneumococcal polymerase chain reaction (PCR)-positive effusions and empyema will be described by month of discharge, age, sex, underlying medical conditions as well as signs and symptoms of pneumonia. Pleural fluid will be tested for the presence of S.pneumoniae deoxyribonucleic acid (DNA) and, if positive, further tested to identify the pneumococcal serotype.
Sponsors
A/Prof Adam Jaffe (Principle Investigator)
Eligibility
Sex/Gender
All
Age
0 to 16 Years
Healthy volunteers
No
Inclusion criteria
Children whose clinical condition necessitates drainage of pleural fluid secondary to pneumonia, and who present with the classical features of empyema; fever, cough, raised white cell count, raised C-reactive protein (CRP) and fluid present on ultrasound.
Exclusion criteria
Those over the age of 16yrs old, and those who do not present to a paediatric hospital
Outcome results
None listed